1. Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors
- Author
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Marie Ntep-Gweth, Philip Joseph, Supachai Tanosmsup, Stuart J. Connolly, Mariëlle Kloosterman, Michael D. Ezekowitz, Guy Amit, Lars Wallentin, Alex Grinvalds, Alvaro Avezum, Shun Fu Lee, Salim Yusuf, Jonas Oldgren, David Conen, Tyler W. Barrett, Ratika Parkash, Isabelle C. Van Gelder, Jorge A. Wong, William F. McIntyre, Jeff S. Healey, and Cardiovascular Centre (CVC)
- Subjects
Male ,COUNTRIES ,medicine.medical_specialty ,Registry ,PROGNOSIS ,Heart disease ,030204 cardiovascular system & hematology ,Left ventricular hypertrophy ,Borderline risk factors ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Lone atrial fibrillation ,Clinical Research ,Risk Factors ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,medicine ,Less-established risk factors ,MANAGEMENT ,Humans ,030212 general & internal medicine ,Registries ,Stroke ,Atrial fibrillation hospitalization ,Heart Failure ,business.industry ,MORTALITY ,DEATH ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Cardiac surgery ,Heart failure ,Cardiology and Cardiovascular Medicine ,business ,Substrate ,30-YEAR FOLLOW-UP ,Kidney disease - Abstract
Aims Data on patient characteristics, prevalence, and outcomes of atrial fibrillation (AF) patients without traditional risk factors, often labelled ‘lone AF’, are sparse. Methods and results The RE-LY AF registry included 15 400 individuals who presented to emergency departments with AF in 47 countries. This analysis focused on patients without traditional risk factors, including age ≥60 years, hypertension, coronary artery disease, heart failure, left ventricular hypertrophy, congenital heart disease, pulmonary disease, valve heart disease, hyperthyroidism, and prior cardiac surgery. Patients without traditional risk factors were compared with age- and region-matched controls with traditional risk factors (1:3 fashion). In 796 (5%) patients, no traditional risk factors were present. However, 98% (779/796) had less-established or borderline risk factors, including borderline hypertension (130–140/80–90 mmHg; 47%), chronic kidney disease (eGFR 30; 19%), diabetes (5%), excessive alcohol intake (>14 units/week; 4%), and smoking (25%). Compared with patients with traditional risk factors (n = 2388), patients without traditional risk factors were more often men (74% vs. 59%, P Conclusion Almost all patients without traditionally defined AF risk factors have less-established or borderline risk factors. These patients have a favourable 1-year prognosis, but risk of AF-related re-hospitalization remains high. Greater emphasis should be placed on recognition and management of less-established or borderline risk factors.
- Published
- 2020